How to Handle Lice

Lice: That dreaded, four-letter word that sends parents and teachers scrambling. These tiny insects are so common that Dr. Jason Yuan, a pediatrician at Le Bonheur Children’s Hospital says they effect more elementary school students in North America than all other communicable diseases combined (with the exception of the common cold). Yet, despite this fact, damaging stereotypes of who gets lice persist.

“A lot of people think only dirty kids can get lice, or that it comes from bad hygiene or the house is dirty. That’s just not true,” says Yuan. Whether your family is clean or dirty, wealthy or poor, athletic or coach potato, anyone can be an unwilling host. Here’s how to avoid infestations — and how to treat them once they occur.

Don’t Share Personal Items

Lice transmission occurs only through direct contact with an infected individual or item, notes Yuan, because lice can’t jump, fly, or hop; they only crawl. This limitation means elementary students are more likely to contract lice than teens since young children share personal items and play close together, often touching heads. Teens, not so much.

However, while incidental or brief contact associated with volleyball, basketball, or riding the team bus is not as likely to allow lice to move from person to person, the closeness of some contact sports works to a louse’s advantage. Even the close quarters of locker rooms offer travel opportunities. Sharing towels, jerseys, T-shirts, hats, helmets, or lockers provides the perfect means for lice to change hosts.

Because lice will happily suck the blood from any scalp, Yuan says the best prevention is not sharing personal items, such as combs, scarves, barrettes, hair bows, or brushes that come in close contact with another’s hair.

When an Outbreak Occurs

A note from school advising of an outbreak or your child’s excessive scratching, especially behind his ears or around the hairline, are good reasons to do a check. However, don’t assume your kid has escaped infection just because he’s not scratching, itchiness may not develop until three to four weeks after an infestation.

Nits (or eggs) are easier to spot. Attached firmly to the base of hair follicles, yellow to white, oval-shaped nits resemble dandruff or dirt that can’t be shaken from hair.

Wet-comb hair. Dampen hair with conditioner and run a comb or nit comb (available in over-the-counter lice medications) through small sections of hair to remove nits.

Treat Immediately

Yuan recommends parents first seek over-the-counter lice medications, such as Nix or RID, as these less expensive options are usually sufficient. However, if these don’t work, contact your pediatrician. Newer prescription remedies, such as Spinosad or topical Ivermectin, may be necessary. As with any medication, follow all directions, including age restrictions and number of treatments deemed safe.

Launder Household Items

While applying household pesticides is not recommended, certain precautions in the home are necessary. Wash any clothing, linens, towels, or other personal items the child has had contact within the last 48 hours. Use hot water, followed by 20 minutes at high-heat in the dryer. Place non-washable items, such as stuffed animals or hats, in a plastic bag, seal tightly, and set aside for at least two weeks to kill lice and nits. Soak combs or brushes in hot water, rubbing alcohol, or medicated shampoo for 10 to 15 minutes, or simply toss. As a final precaution, vacuum carpets and upholstery well, especially in areas your child frequented in the previous two days.

No Need to Ditch School

While many schools have a ‘no nit’ policy, meaning children must be free of nits before returning to school, Yuan says this step is unnecessary. “Kids with lice don’t need to be excluded from school. Just treat them, and let them know to avoid direct contact with other children.”